MSK Malignancy Flashcards
PS - Metastatic bone disesae (8)
Unremitting dull pain Worse at night and doesn't change on position Sharp upon weight bearing Normally comes up quite quickly Hypercalcaemia Pathological # B Sx Sx of SC compression
O/E - metastatic bone disease (3)
Bone tenderness
Decreased range of movement
Local lymphadenopathy
Common sites 1’ tumours to the bones (5)
BLT KP Breast Lung Thyroid Kidney Prostate
DDx mets bone (3)
Multiple myeloma
Lymphoma
Osteomyelitis
Ix suspected bone mets (5)
Skeletal radioisotope scans - mets = hot areas Skeletal XR - sclerotic/lytic lesions CT/MRI CT biopsy Bloods
‘Bad’ XR features suggesting malignancy (5)
Wide zone transition Permeative margin Interruppted periosteal reaction Cortical destruction Lytic
Mx bone pain in mets (5)
Establish 1' diagnosis Analgesia/local radiotherapy to control Bisphosphonates - decrease fracture risk Chemo/hormone therapy = breast/prostate Prophylactic surgery - stabilise joints
What is multiple myeloma
Haem condition of plasma cell proliferation
PS multiple myeloma (CRABBI)
Ca - hypercalcaemia --> constipation, nausea, confusion R - renal (dehydration/thirst, CKD) Anaemia Bleeding Bone destruction - patho # Infection
Ix multiple myeloma
FBC/U+E
Se/urine electrophoresis - Incr IgA/C protein (bence/jones protein)
Bone marrow aspiration
Mx multiple myeloma (3)
Radiotherapy
Spinal decompression + fusion if necess
Type of 1’ bone tumours (3)
Osteosarcoma
Chrondrosarcoma
Osteoma
What is an osteosarcoma
Malignant tumour of osteoblasts
Prognosis osteosarcoma
5y 10%
Who gets osteosarcomas
Children
Which bone is most affected by osteosarcoma
KNee
Which other condition is osteosarcoma associated with?
Paget’s disease
Where does osteosarcoma mets to?
Lung
What is chondrosarcoma
Malignant cartilage forming lesion
Growth - chondrosarcoma
slow
Who gets chondrosarcomas
Adults
Where are chondrosarcomas most commonly?
pelvis
PS 1’ bone tumours (3)
Pain
Mechanical Sx
Pathological #
Mx 1’ bone tumours aims
1’ - survival
2’ - limb preservation
Mx 1’ bone tumour
En-bloc resection + adjuvant chemo/radiotherapy
